应用德尔菲法探索消毒人员队伍建设和培养思路

目的探索构建符合上海市传染病防控需要的消毒人员队伍建设和培养的思路。方法通过德尔菲法结合需求调研、专家咨询,对职业化消毒人员队伍建设和培养思路进行调研。结果疾病预防控制机构、卫生监督、专业学会协会等20名专家参加了咨询,问卷回收率达100.00%。消毒人员重要性评分依次为事中职责、保障措施、事前准入和事后考核。三类消毒人员需求各不相同,消毒核心人员消毒知识技能以及承担工作的能力要求最高,分别为(4.73±0.46)分和(4.73±0.47)分。消毒服务人员任职资格最重要,为(4.90±0.45)分。消毒从业人员承担工作的能力要求最高,为(4.83±0.39)分。培训和知识技能在3类人员中都有着重要地位,且最重要的技能均为个人防护,其次为实际操作能力。结论本次调查专家积极程度和协调程度高,发现目前消毒人员专业队伍建设面临较大挑战。建议加强消毒员的职业认定和保障,同时针对性地分类培养,满足各类消毒人员的职业需求。

江苏省卫生应急人员对传染病防控资源支持情况的评价

目的 了解江苏省卫生应急人员对传染病防控资源支持的评价,为进一步合理科学地改进资源统筹与调配、提升传染病防控能力提供参考。方法 采用多阶段分层随机抽样方法,选取江苏省卫生健康委应急部(处)/疾控局(处)、疾病预防控制中心、传染病专科医院等部门/机构的专业卫生应急人员作为研究对象,就传染病防控资源的支持情况(人力资源支持、物质资源支持、组织制度支持、组织文化氛围支持和决策资源支持)进行现场调查。结果 评价最高的是“组织文化氛围支持”(3.810±0.725)分,评价最低的是“决策资源支持”(2.827±1.047)分;不同机构的卫生应急人员对物质资源支持和组织文化氛围支持的评价差异分别有统计学意义(P <0.05)。结论江苏省传染病防控资源存在决策资源支持不足、应急队伍专业人员配备不足、物质资源投入重医轻防等问题,需要继续积极稳妥地推进地方疾病预防控制机构改革,落实“将健康融入所有政策”,优化资源投入结构,改善公共卫生人员福利待遇,提升风险防范水平,规范社会参与力量。

我国传染病防控人员有效激励水平

目的分析2002—2017年全国31省(自治区、直辖市)传染病防控人力资源的有效激励水平及变化趋势,针对人员激励现状探讨有效激励因素的地区分布情况。方法系统收集中国知网(CNKI)和Web of Science数据库中1997—2017年发表的全国31个省(自治区、直辖市)关于传染病防控人员激励问题的研究文献,运用内容分析法进行评阅,判断人员激励问题的严重程度。将文献中提到的人员激励问题的影响因素分成4类并计数,运用卡方检验分析各地区人员有效激励因素的分布情况。结果当前我国传染病防控队伍的有效激励水平不高,仅为31.84%;而且地区差异大,2017年结果显示,地区之间变异系数为32.44%。2002—2017年,各地传染病防控队伍有效激励的改进幅度有限,增长幅度仅为11.13%。全国范围内,经济类因素成为影响传染病防控人员工作积极性的主要原因,在各类因素中占46.25%。在地区层面,中部地区人员激励水平(28.03%)一直落后于东部地区(35.90%)和西部地区(30.67%)。在有效激励因素上,东部地区对教育类因素的关注度(东部地区为17.53%,中部地区为6.82%,西部地区为6.25%)和西部地区对个人与专业支持类因素的关注度(东部地区为15.46%,中部地区为18.18%,西部地区为35.71%)明显高于其他地区。结论我国传染病防控人员激励机制有待完善,特别是中部地区尤为迫切。经济类因素如薪酬待遇已然成为全国范围内影响人员队伍稳定性的主要因素。此外,西部地区应在改善卫生人员生活与工作条件方面继续加强,而东部地区仍可在人才培养、继续教育方面进一步完善激励机制。

Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019

Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.

Systems thinking in combating infectious diseases

The transmission of infectious diseases is a dynamic process determined by multiple factors originating from disease pathogens and/or parasites,vector species,and human populations.These factors interact with each other and demonstrate the intrinsic mechanisms of the disease transmission temporally,spatially,and socially.In this article,we provide a comprehensive perspective,named as systems thinking,for investigating disease dynamics and associated impact factors,by means of emphasizing the entirety of a system’s components and the complexity of their interrelated behaviors.We further develop the general steps for performing systems approach to tackling infectious diseases in the real-world settings,so as to expand our abilities to understand,predict,and mitigate infectious diseases.

The strategic framework of tuberculosis control and prevention in the elderly:a scoping review towards End TB targets

With the rapid pace of population ageing,tuberculosis(TB)in the elderly increasingly becomes a public health challenge.Despite the increasing burden and high risks for TB in the elderly,targeted strategy has not been well understood and evaluated.We undertook a scoping review to identify current TB strategies,research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets.Databases of Embase,MEDLINE,Global health and EBM reviews were searched for original studies,review articles,and policy papers published in English between January 1990 and December 2015.Articles examining TB strategy,program,guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria.Most of them were qualitative studies,issued in high-and middle-income countries and after 2000.To break the chain of TB transmission and reactivation in the elderly,infection control,interventions of avoiding delay in diagnosis and containment are essential for preventing transmission,especially in elderly institutions and aged immigrants;screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people;optimizing early case-finding with a high index of suspicion,systematic screening for prioritized high-risk groups,initial empirical and adequate follow-up treatment with close monitoring and evaluation,as well as enhanced programmatic management are fundamental pillars for active TB elimination.Evaluation of TB epidemiology,risk factors,impacts and cost-effectiveness of interventions,adopting accurate and rapid diagnostic tools,shorter and less toxic preventive therapy,are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway.The framework and principals identified in this study will help to evaluate and improve current program,develop targeted strategy,as well as raise more discussions on the research priority settings and policy transitions.Given the scarceness of policy and evaluated interventions,as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries,the increasing need of a ready TB program for the elderly warrants further research.

Modeling epidemic spread in transportation networks:A review

The emergence of novel infectious diseases has become a serious global problem.Convenient transportation networks lead to rapid mobilization in the context of globalization,which is an important factor underlying the rapid spread of infectious diseases.Transportation systems can cause the transmission of viruses during the epidemic period,but they also support the reopening of economies after the epidemic.Understanding the mechanism of the impact of mobility on the spread of infectious diseases is thus important,as is establishing the risk model of the spread of infectious diseases in transportation networks.In this study,the basic structure and application of various epidemic spread models are reviewed,including mathematical models,statistical models,network-based models,and simulation models.The advantages and limitations of model applications within transportation systems are analyzed,including dynamic characteristics of epidemic transmission and decision supports for management and control.Lastly,research trends and prospects are discussed.It is suggested that there is a need for more in-depth research to examine the mutual feedback mechanism of epidemics and individual behavior,as well as the proposal and evaluation of intervention measures.The findings in this study can help evaluate disease intervention strategies,provide decision supports for transport policy during the epidemic period,and ameliorate the deficiencies of the existing system.